Mixed factitious disorder presenting as AIDS
Acquired Immunodeficiency Syndrome
No other health crisis has received as much attention as the current AIDS epidemic. The amount of detailed information available to the public, strong confidentiality laws, and a sympathetic health care system make it easy for persons feigning AIDS to obtain treatment, hospital admission, or both. Most health care workers, overwhelmed by the tragic nature of this so-far-hopeless illness, find it hard to even consider the possibility of such a deception. Since 1986, a few reports in the medical literature have described physically healthy patients who claimed to have AIDS. Some were thought to be feigning AIDS for clear secondary gain. One sought to obtain admission to a study of azidothymidine (1), another to obtain drugs (2). One patient who was HIV-positive sought treatment to gain shelter and financial aid and to avoid a court hearing (3). After extensive medical evaluations, some patients were found to have factitious disorders (4) or to fit the classical description of Munchausen's syndrome (5,6). However, a careful review of the literature revealed only one letter (7) and a single case report (8) describing factitious AIDS patients who gained entry to a psychiatric unit.